Italian Citizenship: Foreigners in Italian Healthcare

The Italian healthcare system is experiencing a complex reality. According to recent data from the Associazione di Medici di Origine Straniera in Italia (AMSI - Association of Physicians of Foreign Origin in Italy), healthcare professionals from other countries already represent more than 10% of the sector's workforce. There are 123,810 foreign professionals actively working in the country, including doctors, nurses, dentists, physiotherapists, and pharmacists.

The Numbers Revealing a Critical Dependency

Among the foreign professionals in the Italian healthcare system, the following stand out:

• 49,500 doctors of foreign origin
• 45,200 nurses from other countries
• Thousands of dentists, physiotherapists, pharmacists, and psychologists

According to Foad Aodi, president of AMSI, the contribution of these professionals has been fundamental to maintaining the system. Between 2023 and 2025, the work of foreigners prevented the closure of approximately 5,200 hospital departments and services across the country.

The Paradox: Essential, But Without Stability

Despite being indispensable to the system's functioning, approximately 65% of these professionals do not hold Italian citizenship. This means they are legally barred from participating in public competitions (concorsi pubblici) for permanent positions in the health service.

Only 35% of foreign healthcare professionals are Italian citizens. Of these, more than half (53%) work in critical areas such as:

• Family medicine
• Contracted pediatrics
• Emergency rooms
• Night and holiday medical guard services (guardia medica)

The "Covid Deroga" and Its Risks

The sector still operates under the so-called "deroga Covid" (Covid waiver) — a regulatory exception that allows hiring without the rigorous verification of foreign titles and diplomas. Filippo Anelli, president of the National Federation of Medical Orders (Fnomceo), has publicly warned about the risks of this measure.

The responsibility for verifying diplomas lies with the Italian regions, but oversight has been flawed. According to Anelli, this gap could constitute the illegal practice of the profession in some cases. The lack of adequate control represents a risk for both professionals and patients.

The president of AMSI also highlights that insufficient mastery of the Italian language by some professionals can compromise the quality of care, emphasizing the need for more robust integration programs.

The Italian Brain Drain

While foreigners arrive to fill vacancies, Italian doctors and nurses are leaving the country in search of better conditions. The numbers are alarming:

• 6,000 nurses left Italy between 2023 and 2025
• 4,000 doctors emigrated during the same period

The main causes cited include:

• Burnout — chronic professional exhaustion
• Remuneration considered insufficient
• Excessive bureaucracy in the healthcare system
• High risk of legal proceedings

Young doctors, in particular, have been avoiding specialties such as emergency medicine due to adverse working conditions.

What This Means for Those Seeking Italian Citizenship

For those seeking Italian citizenship, these data reveal an interesting scenario. The Italian healthcare job market is eager for qualified professionals, and citizenship opens significant doors:

• Access to public competitions — the possibility of permanent and stable positions
• Facilitated recognition of diplomas — citizens have more streamlined processes
• Full labor rights — without the limitations imposed on foreigners
• Mobility within the European Union — the ability to work in any country within the bloc

The Importance of Citizenship for Healthcare Professionals

If you are a healthcare professional with Italian ancestry, obtaining citizenship can be a game-changer for your career. In addition to ensuring professional stability, Italian citizenship offers:

• Access to the Italian healthcare system as a citizen
• Possibility of specialization in European universities
• Professional recognition throughout the European Union
• Right to a pension in the Italian social security system

Conclusion

AMSI data reveal an Italy dependent on foreign professionals to keep its healthcare system running. At the same time, bureaucratic barriers and the lack of citizenship limit the opportunities for these essential workers.

For those with the right to Italian citizenship, especially those working in the healthcare field, the current moment presents unique opportunities. The demand for qualified professionals is high, and citizenship can be the key to a stable and successful career in Europe.

Source: Data released by the Association of Physicians of Foreign Origin in Italy (AMSI) and the National Federation of the Orders of Doctors (Fnomceo), January 2025.